Cumann Baire Fág-a-Bealach C.L.G. Faughs GAA Club / Faughs Celtic Club Wellington Lane, Templeogue, 6W Phone: 01 4903566, Fax: 01 4902098 Email: [email protected] Web: www.faughs.ie Register Online at www.faughs.ie 2019 Adult Registration Form Use separate Juveniles Form for U18s

Name: Address: Name in Irish: (players only) Male or Landline 1 Date of Birth: (players only) Female: Phone No.:

Mobile No.: Email:

Membership Type: Fee (See below) Amount:

Name: Address: Name in Irish: (players only) Male or Landline 2 Date of Birth: (players only) Female: Phone No.: Mobile No.: Email:

Membership Type: Fee (See below) Amount:

Name: Address: Name in Irish: (players only)

3 Date of Birth: Male or Landline (players only) Female: Phone No.: Mobile No.: Email:

Membership Type: Fee (See below) Amount:

Total Fee Amount: € Registration fees 2019

Adult Player €200.00 OAP €25.00 Student Player €130.00 Social €50.00 Adult Non Player €120.00 Mentor €50.00 Family Membership up to 3 members €350.00 Family Membership more than 3 members €380.00 Mentor Family Membership (Juvenile) €230.00 (includes juvenile player members only) Declaration  I / we hereby apply to Faughs GAA Club/Faughs Celtic Camogie Club for membership of the club and membership of the Cumann Lúthchleas Gael (The Gaelic Athletic Association)/Camogie Associaton. I / we subscribe to and undertake to further the aims and objectives of the club and to abide by its rules, and I / we attach herewith the appropriate membership fee .  I accept that I / we may be photographed for publicity while taking part in club activities and may feature in photos and team pictures on the official club website and club publications.  I accept that the the club may send me / us emails relating to club events and promotions. Emails will have an option to unsubscribe from further emails. Signature 1 Signature 2 Signature 3